Empathy

By Ashley Winters

What is Empathy?

“to put yourself in his or her shoes”

http://www.youtube.com/watch?v=yOjL6baOwu0

Background Info

-origin of the word empathy dates back to the 1880’s -German psychologist Theodore Lipps-coined the term “einfuhlung” (in feeling)-then meant to describe the emotional appreciation

of another’s feelings-now commonly referred to as process of

understanding a person’s subjective experience by vicariously sharing that experience while maintaining an observant stance

Medical Field

Empathy is commonly referred to in the medical work force because it applies directly to a characteristic nurses and physicians need to have in order to diagnose and treat patients.

Differences in Similar Terms

• Pity -describes a relationship which separates physician and patient

-often condescending and may entail feelings of contempt and rejection

• Sympathy -physician experiences feelings as if he or she were the sufferer -shared feelings

• Empathy -“borrows” another’s feelings to observe, feel, and understand but not to take them upon ourselves

DYAMOND’S CONTRIBUTION (1949)

-empathetic person can imaginatively take the role of another and can understand and accurately predict the person’s thoughts, feelings, and actions

Evolution

-term originally believed by all researchers to be innate and impossible to acquire

-either born with it or not-now considered teachable and learnable by

some-named as essential learning objective by the

American Association of Medical Colleges

American Association of Medical Colleges Could Be Referring To. . .

Clinical Empathy-expanded defintion of empathy which includes

-emotive: ability to imagine patient’s emotions and perspectives

-moral: the physician’s internal motivation to empathize

-cognitive: intellectual ability to identify and understand patient’s emotions and perspectives

-behavioral: ability to convey understanding of those emotions and perspectives back to the patient

Behavioral Empathy

-empathy mediates helping behaviors or volunteering (nursing)

-associated with higher life statistics, well being, and health promotion

-volunteerism provides man-power, saves money, and is the backbone of many organizations

Measurement of Empathy

-more than 20 different ways to measure-very difficult to measure-most studies use paper and pencil self

evaluationsPopular Ones Include:

-Interpersonal Reactivity Index (IRI)-Empathy Construct Rating Scale (ECRS)-Balanced Emotional Empathy Scale

Study

-Hogan Empathy Scale and Adjective Check List Empathy Scale

-tested 43 adults-ages 63-96-both test results showed mean score of older

generations was lower than that of the younger

Medical Models

“The Four Habits Model” (Permenente Medical Group)-Invest in the beginning, Elicit the patient’s perspective, Demonstrate empathy, Invest in the end

“The Four E’s” ( Bayer Institute for Health Care Communication)-Engage, Empathize, Educate, Enlist

“The PEARLS” (American Academy on Physician and Patient)-Partnership, Empathy, Apology, Respect, Legitimization, Support

Key Steps to Effective Empathy-Frederic Platt-

-Recognizing presence of strong feelings in the clinical setting (fear, grief, anger, disappointment)

-Pausing to imagine how the patient might be feeling-Stating your perception of the patient’s feeling (I can Imagine

that must be…)(It sounds like you’re upset about…)

-Legitimizing that feeling-Respecting the patient’s effort to cope with the predicament-Offering support and partnership (I’m committed to work

with you to…)(Let’s see what we can do together to…)

5 Types of Empathetic Responses1) reflective: “I can see that you are…”

“You seem to be…about this”2) legitimizing: involves putting yourself in the other person’s

place “I can understand why you’re feeling…”

3) supportive: suggests that you want to help in a constructive way “I’ll be here if you have any questions or need any advice”

4) partnership building: suggests that you would like to work as a team to solve the problem “We’ll work together to do what’s best”

5) respectful: expresses admiration for the way in which the patient is dealing with the situation “You are coping well with this”

5 Different States of Empathy

-different names for each term-different ideas behind each name-each is part of the mosaic that creates empathy

as a whole, even though some ideas seem conflicting

Empathy As A. . .

1) Human Trait

-innate-natural ability-cannot be taught but can be identified,

reinforced, and refined

2) Professional Trait

-learned communication skill-comprised of cognitive and behavioral ideas used

to convey understanding of clients reality back to him or her

-learned phenomenon-emotional distance-appropriate professional response -objectivity-therapeutic role

3) Communications Process

-goal is to leave the client feeling understood-can be non-verbal (mentioned later)-3 primary stages

a)empathy potentialb)empathy expressedc)empathy recieved

4) Caring

-understanding of a situation and compulsion ti act because of experience of understanding

-goal is to alleviate emotional sufferinga)identification: losing consciousness of self and becoming

engrossed in the experience/ situation of anotherb)introjection: emotionally experiencing what another is

feelingc)detachment: responsiveness to sufferingd)patient response: physical needs met or emotional

suffering alleviated

5) Special Relationship

-reciprocal relationship to develop over time-consists of 3 sequential stages

a)initiatingb)buildingc)sustaining

Types of Non-Verbal Empathy

-tone of voice (lowered, sympathetic)-facial expression (concerned)-touch (caring, reassuring)

Ways to Improve Empathy

-review videotaped encounters-do what feels comfortable-develop styles that match your personality

Barriers to Giving Empathy

-“there is not enough time during the visit to give empathy”

-“giving empathy is emotionally exhausting for me”

-“I don’t want to open that Pandora’s box”-“I’m concerned that if I use all my empathy at

work I won’t have anything left for family”-“I haven’t had enough training in empathetic

communication”

Tying It All Together With Obama

http://www.youtube.com/watch?v=LGHbbJ5xz3g&feature=related

ReferencesAn Introduction to Empathy (n.d.). Lifelong Independent Veterinary Education. Retrieved

December 7, 2009, from http://www.live.ac.uk/documents/intro_to_empathy.pdfJames, T. H. (2003). An Overview of Empathy. A Focus on Patient-Centered Care and Office

Practice Management, 7. Retrieved from http://xnet.kp.org/permanentejournal/fall03/cpc.html

Kunyk, D., & Olson, J. (2001). Clarification of conceptualizations of empathy. Journal of Advanced Nursing, 35(3), 317-325. doi: 10.1046/j.1365-2648.2001.01848.x.

May, B., & Alligood, M. (2000). BASIC EMPATHY IN OLDER ADULTS: CONCEPTUALIZATION, MEASUREMENT, AND APPLICATION. Issues in Mental Health Nursing, 21(4), 375-386. doi: 10.1080/016/28400247997.

Mehrabian, A., & Epstein, N. (1972). A measure of emotional empathy. Journal of Personality. Retrieved from http://dionysus.psych.wisc.edu/Lit/Articles/MehrabianA1972a.pdf

Stephen, K., & Baernstein, A. (2006). Educating for Empathy. JGIM: Journal of General Internal Medicine, 21(5), 524-530. doi: 10.1111/j.1525-1497.2006.00443.x.